Pubdate: Mon, 05 Feb 2007 Source: Independent (Malta) Copyright: 2007, Standard Publications Ltd Contact: http://www.independent.com.mt/ Details: http://www.mapinc.org/media/2884 Author: Juan Ameen Bookmark: http://www.mapinc.org/coke.htm (Cocaine) COCAINE VACCINE - TO USE OR NOT TO USE IT? Although a vaccine for cocaine addiction has been discovered, as with every scientific discovery it is now up to society to choose whether to make use of it or not, said Professor Richard Muscat. Prof. Muscat, Professor of Behavioural Neuroscience at the University of Malta was commissioned by the Pompidou Group to write a paper discussing the implications of the TA-CD vaccine. The Pompidou Group is an inter-government body formed in 1971 that studies and compares drug use trends in Europe and was instrumental in setting up the European School Survey Project on Alcohol and other Drugs (ESPAD Report). The concept behind the TA-CD vaccine is very simple: cocaine blocks nerve cells from absorbing dopamine, a chemical substance produced by the brain that controls pain relief. The blockage creates an overabundance of dopamine in between nerve cells, leading to what is known as "a cocaine high." The TA-CD vaccine makes ingested cocaine attach itself to a larger protein molecule, while at the same time causing the immune system to recognise and combat this larger protein molecule before the attached cocaine is able to reach the brain. The TA-CD vaccine does not actually stop someone from wanting to consume cocaine, but it does inhibit the "high". Studies conducted in the US and in England show promising results: the vaccine was developed in the UK and was tested on 18 cocaine addicts over a period of 14 weeks. According to the results, three quarters of the vaccinated group of addicts were drug free for a period of three months. Furthermore, after six months, both those who had relapsed and those who had not, said that the "high" was not as strong as before taking the vaccine. In the US, where studies were funded in part by the US National Institute on Drug Abuse and which used the largest number of subjects, patients were able to remain off cocaine for six months. Additionally, parallel but separate studies indicate that an individual's pre-existing brain chemistry can increase his or her predisposition to become addicted to cocaine, opening the door to prevention strategies that test for this predisposition. At present there are no medical treatments available for cocaine addiction, Prof. Muscat said. The reason appears to be the mechanism of action through which cocaine exerts its effects on the brain neurotransmitters dopamine and serotonin. Heroin binds to brain opioid receptors, such as the mu receptors, and therefore mimics the action of the brain's own endorphins. However, cocaine inhibits the reabsorption of dopamine and seratonin, leading to a build-up of the transmitter, thus prolonging and strengthening its effect, he explained. Prof. Muscat said it does not mean that it is not possible to develop a medical treatment for cocaine addiction - only that it may be more difficult to do so and may involve different concepts. Every single organism has a pleasure pathway wired in his or her brain, he explained. "All a drug does is amplify the feel-good factor." Furthermore, the TA-CD vaccine does not switch off the craving for the drug. "What researchers are suggesting is that it is administered only after the person has undergone rehabilitation." Prof. Muscat explained that research has found that 50 per cent of dependent substance abusers may be genetically related. "Therefore this raises a number of ethical issues such as: do we administer the vaccine to 10-year-olds who have a predisposition for substance dependency?" queried Prof. Muscat. However, even though the vaccine has yet to be approved for the general population, researchers from around the world are already raising objections to widespread use of the vaccine on ethical grounds. In his paper Biomedical research in the drugs field, Prof. Muscat discusses the ethical issues behind the vaccine. Should it be used, asked Prof. Muscat, "for example where adolescents are considered to be at risk of developing cocaine dependency? Do we vaccinate all young people with increased vulnerability?" Prof. Muscat pointed out that as not every individual's brain chemistry reacts to cocaine in the same way, administering a vaccine indiscriminately would be cause for concern. However, he added, administering the vaccine to people identified as having a predisposition to cocaine addiction, might end up stigmatising them. - --- MAP posted-by: Beth Wehrman